The Alabama Project

The Alabama Project: Civil Rights in a New Era of Healthcare Challenges

Story by Cynthia Ryan, Photos by David Jay

Fifty years since the Civil Rights Movement took center stage in Alabama, the conversation about treating all human beings equitably continues. While many outside Birmingham imagine our city replete with lunch counter sit-ins, water hoses, police dogs and devastating violence, those of us who make our home here know better. We recognize the beauty, richness and pride that characterize Birmingham, at the same time we understand the impossibility of portraying the ongoing struggle for a host of civil rights through a few images frozen in time.

Fair and respectful treatment of people involves more than assessing the color of their skin. A multitude of factors (family structure, education level, employment status and so on) influence the privileges that some enjoy and the restrictions on others seeking the most basic of needs: enough to eat, reliable shelter, or adequate health care. In 2013, we are called to respond to the complexities of circumstance that threaten the rights of many of our neighbors, perhaps ourselves.

It’s a challenge that intrigued fashion photographer David Jay, who recently came to Alabama to document the experiences of five young women in the state living with breast cancer. Best known for The SCAR Project, a traveling exhibit of large-scale portraits of breast cancer survivors under 40 launched seven years ago when his dear friend Pauline was diagnosed at age 29, David hopes The Alabama Project demonstrates the everyday realities of each woman’s walk through the disease, including those roadblocks that make a survivor’s journey hers alone.

Through the images and stories of Brittney, Whitni, Leah, Melanie, and Raquel, we aim to reveal more than a common plight in the face of a frightening illness. Rather, we show the unique concerns that mark every individual’s struggle for health and happiness.

“It’s not just the storm. It’s how you weather it.”

Brittney Bass

Twenty-six-year-old Brittney Bass is a survivor. In 2005, she was attending Loyola University in New Orleans when Hurricane Katrina hit. Six years later, she experienced the Alabama tornados, losing her apartment to the storm. When breast cancer suddenly became her new reality at age 24, Brittney admits that she needed some time to process the events of her life of late.

“I sat myself down in the dark . . . and thought what have I done, where have I gone wrong? Why do these things keep happening?” she said, tears streaming down her face.

The challenges of getting through treatment for Stage 1 Triple-negative breast cancer—surgery, chemotherapy, and radiation—were great. And Brittney carried another burden as a student who depended on her college health insurance plan to pay her medical bills.

Brittney smiles when she talks about the good fortune that finally came her way amid the turmoil. Brittney’s father told her about a new health care package devised by President Obama that would allow her to stay on her parents’ policy until age 26. She no longer had the stress of staying in school while fighting off the side effects of treatment just to receive quality care.

More importantly, Brittney met and married Brandon Gray.

“You get to the point [with this illness] where you’re vulnerable and strong at the same time,” Brittney offered. “That’s when you’re most transparent, and that’s when we fell in love.”

“I might look like a regular girl, but there’s a lot more behind my smile.”

“I got a call from the doctor on October 25 at 3:23 p.m.,” Whitni recalled. “The biopsy [of the lump in her breast] came back as breast cancer. I hung up. It hit me. I cried and called my mom.”

Accompanied by her mom, Whitni followed through on an appointment with her doctor. And while Whitni agreed to a lumpectomy, her mom disagreed with the medical team that her daughter should undergo chemotherapy. Instead, she urged Whitni to try a more holistic approach.

“That’s when everything got really hard,” Whitni admitted. “My mom, she’s Seventh Day Adventist, and she doesn’t believe you need anything but natural herbs, exercise, that kind of thing to get better.”

In the months that followed, both her mom and her oncologist attempted to persuade Whitni to follow different courses of treatment. More than two years later, Whitni has completed some of the recommended chemotherapy, all of the suggested radiation treatments, and a less aggressive surgical option than ordered by her physician. She’s also spent time at a lifestyle center in Tennessee discovered by her mom.

At the moment, Whitni is staying with a friend until she can begin working enough hours as a Respiratory Therapist to pay her own rent. Otherwise, she anticipates going to a women’s shelter.

“I know everybody just wants what’s best,” Whitni acknowledged. “For me, it’s about having not only a long life, but quality of life.”

“You can’t change your situation, but you can tell your story and help other women.”

Melanie Hoskins

Melanie Hoskins, 32, had been working as an MRI Technologist at UAB for seven months when she learned she had Stage 2 Triple-negative breast cancer in 2010. Specialists in oncology, radiology, surgery, and fertility ushered her through the system as smoothly as possible.

Although Melanie had medical insurance at the time of her diagnosis, she and husband Darrius still worried about paying for expensive Neupogen injections she needed during chemotherapy to increase her white blood cell count and covering numerous copays for doctors’ visits and other procedures. Melanie and Darrius also hope to have children someday, and they knew that the cost for IVF would be steep.

In an effort to manage those bills not covered by insurance, Melanie designed bracelets that friends and family purchased. Eventually, she also created a t-shirt for her team members to wear during the Susan G. Komen Race for the Cure. The shirt attracted attention, and soon, others at the race wanted to know how to get one of their own.

Thanks to her resourcefulness and network of supporters, Melanie was able to address the gap between health insurance benefits and the remaining cost of medical care. She realizes how fortunate she was and hopes for a cancer-free future.

“I know from working in MRI that if the cancer returns it might not be [limited to] my breast,” Melanie told me. “I’ve got to be content with my life right now.”

“The pictures David took aren’t just about the scar. They show a girl who’s happy to be alive.”

Leah Price

Twenty-year-old Leah Price is passionate about many things. She adores animals, especially her cat Nubby, who she rescued from a McDonald’s parking lot, and her two dogs, Holly and Chewy. She and boyfriend Tyler Rensted enjoy music and movies. And she hopes to meet Betty White someday.

“She’s my idol,” Leah told me. “She is so sweet and one of my favorite actresses. She’s just done so much.”

Surrounded by posters of pop stars and an autographed photo of Ms. White, Leah looks like any young woman who’s ready to pursue her dreams. But diagnosed at age 18 with Stage 3 estrogen receptor-positive breast cancer, Leah has other things to attend to along the way.

She shares a bedroom with Carley, Tyler’s sister, since she’s currently living with his family. Leah’s mom suffers from rheumatoid arthritis and gets by on disability payments, while dad Richard works as a truck driver transporting medicine. The two divorced when Leah was eight years old. Leah stayed with her older sister throughout most of her treatments for breast cancer, but returned to Tyler’s house afterwards.

Leah is hopeful about the future and wants to become a make-up artist one day. For now, her focus lies elsewhere. She holds down a part-time job as a cashier at Dollar General, is recovering from the reconstructive surgery finally approved by Medicaid, and struggles to manage the mounting medical bills that went unpaid after her dad lost his job (and insurance to cover Leah’s expenses) and before Medicaid kicked in.

“I’ll get there,” she said.

Raquel Smith

As Raquel Smith, 30, took me through her experiences since being diagnosed with Stage 2B Triple-negative breast cancer at age 27, she’d pause occasionally to catch her breath.

Undergoing treatment for breast cancer and managing the flood of emotions that come with the territory is enough to handle for most survivors. But Raquel has dealt with far more. She was mom to one-year-old Rose when diagnosed, and midway through Raquel’s radiation treatments, doctors discovered that she was pregnant with another child.

“Every day, I would pray on my stomach,” she shared. “I put it in God’s hands to show me the reason for all of this happening.” Baby Rob arrived in January 2012, happy and healthy.

Throughout her treatment for breast cancer and during the pregnancy, Raquel’s health insurance coverage was dropped and renewed, medications approved and then denied. Eventually, she needed somewhere to take Rose and Rob so that she could complete daily therapy on her arms post-mastectomy.

“I didn’t have the income to put them into a daycare program, but I got approved by someone in Montgomery to start taking my kids to Head Start,” Raquel said. “It’s been a blessing.”